ESTRO 35 2016 S683
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analysis with more advanced RT technique is needed to
assess the future role of RT in orbital tumors.
EP-1476
General fatigue during the period of radiotherapy; clinical
usefulness of Japanese herbal medicine.
N. Yoshikawa
1
Osaka Medical College, Radiology, Takatsuki, Japan
1
, H. Yoshioka
1
, K. Yoshida
1
, T. Shimbo
1
, Y.
Uesugi
1
, Y. Narumi
1
Purpose or Objective:
Breast cancer patients receiving post-
operative radiotherapy (RT) experience adverse effects and
general fatigue is one of them. Although it is often not severe
enough to interrupt the course of RT, it negatively affects
quality of life. Some Japanese herbal medicines such as TJ-41
(Hochu-ekki-to) are effective for fatigue and are often used
in daily practice. The purpose of this study is to assess
radiation-induced fatigue (RIF) in detail and investigate the
effect of Japanese herbal medicine.
Material and Methods:
Breast cancer patients who received
post-operative RT and agreed to answer a patient self-
reporting questionnaire (FACIT-F; Functional Assessment of
Chronic Illness Therapy) were eligible for this study. We
excluded patients who were receiving chemotherapy
concurrently. RIF was defined as fatigue which occurred
during the period of radiotherapy and there were no causes
for the fatigue other than the radiotherapy. The FACIT-F
questionnaire was answered before RT, at one week after the
beginning of RT, at the end of RT and one month after the
end of RT. We prescribed TJ-41 to the RIF patients during the
radiotherapy. We defined as responders the patients who
experienced improvements in RIF and hoped for further
prescription.
Results:
Fifty-two patients were enrolled for this study. RIF
was observed in 24 (46 %) patients. On univariate analysis,
the statistically significant predictor of RIF was the score of
FACIT-F before RT. TJ-41 was administered to 9 patients and
8 of them (89 %) were responders.
Conclusion:
RIF was common in breast cancer patients
receiving post-operative RT and TJ-41 was effective for the
RIF patients and improved their quality of life. However,
these results may lack objectivity and the study was
conducted with no placebo group. Improvement in objectivity
of the assessment and a comparative study will be needed.
EP-1477
Radiotherapy-Hyperthermia: outcome/toxicity in the
superficial recurrent/metastatic tumors
E. Garibaldi
1
Istituto di Candiolo- IRCCS, Department of Radiotherapy and
Radiation Oncology, Candiolo, Italy
1
, A. Di Dia
2
, E. Delmastro
1
, G. Belli
1
, M. Gatti
1
,
G. Cattari
1
, A. Salatino
1
, S. Squintu
1
, M. Poli
2
, A. Miranti
2
, P.
Gabriele
1
2
Istituto di Candiolo-IRCCS, Medical Physics, Candiolo, Italy
Purpose or Objective:
Hyperthermia is a powerful
radiosensitizer for treatment of superficial tumors. Several
trials showed an advantage of combining radiotherapy with
hyperthermia in terms of both local tumor control and overall
survival. The purpose of this study is to evaluate both
efficacy and toxicity of radiotherapy-hyperthermia (RT-HT) in
the treatment of superficial recurrent and metastatic tumors
in patients previously or not previously irradiated.
Material and Methods:
In our Institution twenty-three
patients (mean age 71,4 years; range: 51-88) with
histologically confirmed superficial recurrent/metastatic
tumors were enrolled: 11 breast carcinoma, 6 head&neck
cancer, 2 malignant melanoma, 2 sarcomas, 1 uterine
adenocarcinoma and 1 hepatocarcinoma. Patients underwent
radiotherapy treatment using 3D-conformal radiotherapy
(8/23) or Helical Tomotherapy (15/23). External beam
radiotherapy was delivered in 6-27 fractions of 1.8-5 Gy for a
total dose of 20-57.5 Gy (mean external dose: 41 Gy).
Prescribed dose was established taken into account, of the
previous radiation doses, in previously irradiated patients,
Karnofsky performance status and patient compliance.
Hyperthermia treatment was performed with an
electromagnetic superficial applicator operating at the
frequency of 434 MHz. HT session was delivered once/twice
weekly during the period of external radiotherapy, 1-2 hours
after radiotherapy, to a mean total of 5 treatments [range:
1-9 sessions]. Termocouples were used to evaluate
temperature distribution map. Average, maximum and
minimum temperature parameters were recorded during
hyperthermia treatment. The treatment goal was to reach
40- 42°C in > 90% (T90) of measured points for a duration of
60 minutes. Acute and late toxicity was evaluated according
to the CTCAE criteria. Local control was assessed after the
end of the treatment on the basis of the RECIST Criteria.
Results:
During hyperthermia treatment the median
temperature reached was 40.5 °C [range: 39 – 42.9°C].
During the radiotherapy in association with hyperthermia 2
pts (10%) had G3 toxicity and one of these interrupted the
treatment. One pt had acute cutaneous toxicity ≥ G3 at 1
month. No pts had toxicity ≥ G2 at 3 and 6 months. No
toxicity was observed at 12 months. The mean follow-up was
10 months (range 3-22 months). Four pts (17%) had a
complete response (CR), 11 pts ( 48%) had a partial response
(PR),7 pts (30%) had a stable disease, (SD) and only 1 pt (4%)
had progression disease (PD) and subsequently died. The
Local control rate was 95%. Univariate analysis showed that
Tmean,Tmax, Tmin,T90 parameters were not associated with
local control rate.
Conclusion:
Radio-hyperthermia can result in an effective
approach, particularly in previously irradiated patients or in
radio-resistant tumors. Our results show that Radio-
Hyperthermia is an useful combined treatment with a good
local control rate and a very high patient compliance.
EP-1478
Low Dose Radiation therapy of degenerative painful
osteoarthritis
S. Payano
1
Hospital Universitario Madrid Sanchinarro - Grupo Hospital
de Madrid, Oncologia Radioterápica, Madrid, Spain
1
, A. Montero Luis
1
, O. Hernando Requejo
1
, J.
Valero Albarran
1
, M. Lopez Gonzalez
1
, R. Ciervide Jurio
1
, E.
Sanchez Saugar
1
, X. Chen
1
, C. Rubio Rodriguez
1
Purpose or Objective:
The purpose of this study is to
evaluate the decrease in pain of patients treated with low-
dose radiation therapy in osteoarthritis.
Material and Methods:
From April 2015 to September 2015,
11 patients (10 female and 1 men) were treated with low
dose radiotherapy for pain control. All patients were
refractory to conventional therapy prior to irradiation.
13 joints (6 bursitis and 7 arthrosis): 4 trochanteritis, 5
knees, 1 left thumb rhizarthrosis, 2 metacarpophalangeal
joint and 1 right epicondylitis were treated.
The median age was 69 years (range 46-89) with a median
follow-up period of 3 months (range 0-6). Painful status was
measured by visual analogue scale (VAS), with a median pre-
treatment value of VAS= 7(range 4-9).
The radiotherapy dose of 6 Gy was delivered in 6 alternate
days fractions of 1 Gy per fraction. In those patient with no
pain relive post-treatment with VAS of or above 6 a second
course of radiotherapy was proposed.
The second RT series started 8 weeks after the first RT
series.
Results:
The analysis was performed before the treatment
and at the last follow-up. With a median VAS = 5 (range 0-8)
7 patients achieved pain relief, 3 patients underwent a
second course of radiotherapy with identical dose, and 1
patient showed no change in pain. Daily requirements of
analgesic were removed of reduced in 5 patients, subjective
pain perception of response to irradiation evaluated at time
of last visit regarding pre-treatment status was considered as
“better” by 73% of patient. No patients presented acute or
late complications attribute to radiation therapy.